A survey of patients with lung cancer conducted as COVID-19 pandemic shelter-in-place lockdowns were first easing in June 2020 in the United States revealed substantial anxieties about vulnerability to severe illness and access to care.
Those concerns may be amplified, said study investigator Jessica Selig, of the LUNGevity Foundation, Chicago, IL, at the 2021 International Association for the Study of Lung Cancer (IASLC) meeting, given the progression of the pandemic since then.
Because of patient-specific factors such as smoking history or immunosuppressive treatments and COVID-19’s impact on the lungs, patients with lung cancer are particularly vulnerable to severe forms of COVID-19, according to Ms Selig.
The survey was designed to analyze whether patients with lung cancer are prepared to navigate healthcare in a post–shelter-in-place era.
The survey, which was sponsored by LUNGevity, a patient advocacy organization, was conducted between June 10, 2020, and June 25, 2020, and included responses from 302 patients with lung cancer and caregivers.
Most respondents (97%) were patients with non–small-cell lung cancer, and many (33%) were living in COVID-19 hotspots at that period. Furthermore, 61% of the respondents were receiving active treatment for lung cancer, and 30% had no evidence of disease or were considered cured. A total of 64% of the participants were aged <66 years.
The survey revealed that nearly all the patients with lung cancer were concerned that the pandemic would affect their cancer care. The concern was greater in younger patients and among those living in coronavirus hotspots.
Older patients and those living in hotspots were more likely to spend more than 4 hours per week seeking COVID-19 information, and approximately 66% spent 1 to 4 hours doing so.
The respondents placed greater trust in information coming from their physicians or advocacy groups, and rated these sources’ overall reliability as 6.2 (scale, 1-10); by contrast, they rated online sources as 2.9.
A total of 45% of the respondents worried about accessing care, and those who had no evidence of disease or were considered cured were more worried, because of fear of recurrence, than the patients who were receiving active treatment.
Based on the survey results, the top concern (65.6%) that patients with lung cancer had about post–shelter-in-place care was, “I am still at higher risk for a severe case of COVID-19 because I have lung cancer.” In all, 43.1% of the patients affirmed the statement, “I will still be at risk of exposure to COVID-19 when getting lab tests, CT scans or MRIs.” Approximately 32.2% of respondents agreed with the statement, “I am still at risk of exposure to COVID-19 at my cancer clinic.”
In addition, 46% of survey respondents reported interruptions in their ability to see their doctors, and 18% had increased difficulties in receiving appropriate care.
“Our study reveals that lung cancer patients continue to feel vulnerable and ill-equipped to navigate cancer care post–shelter in place,” Ms Selig and colleagues concluded. “Indeed, patient-specific factors (age and treatment status) and local COVID-19 caseload are important predictors of patient worries and access to healthcare, and should be taken into account both during patient–physician discussions and planning lung cancer care at a systems level.”
Heather A. Wakelee, MD, IASLC President-Elect, and Deputy Director, Stanford Cancer Institute, CA, commented on these findings. “These findings show the COVID-19 impact on the patient experience, on their care, as well as on their psychological distress,” Dr Wakelee said. “They highlight some critical issues that we all need to be mindful of that are going to be with us for some time even after the pandemic has moved on.”